Currently there is a great acceptance in medicine and dentistry that clinical practice should be “evidence-based” as much as possible. That is why multiple works have been published aimed at decreasing radiation doses in the different types of imaging modalities used in dentistry, since the greater effect of radiation, especially in children, forces us to take necessary measures to rationalize its use, especially with Cone Beam computed tomography (CBCT), the method that provides the highest doses in dentistry. This review was written using such an approach with the purpose of rationalizing the radiation dose in our patients. In order to formulate recommendations that contribute to the optimization of the use of ionizing radiation in dentistry, the SEDENTEXCT project team compiled and analyzed relevant publications in the literature, guidelines that have demonstrated their efficiency in the past, thus helping to see with different perspectives the dose received by patients, and with this, it is recommended taking into account this document so as to prescribe more adequately the complementary examinations that we use on a daily basis.

Objective: To evaluate the ponticulus posticus according to the skeletal relationship found in strict lateral radiographs at the Centro Dental Docente of the Universidad Peruana Cayetano Heredia during the period 2015–2017, using the classification according to the degree of mineralization described by Selby and Steiner’s skeletal relationship classification. Material and methods: It was performed on digital strict lateral radiographs using a 20-inch screen using the SIDEXIS XG program, observing the degree of mineralization of the ponticulus posticus: without evidence of the bony spicule over the vertebral artery = absent bridge, when spicule formation and/or calcification was noted or evident in the middle of the bridge or incompletely = partial bridge, when the bony arch was evident finished visualizing = complete bridge and the classification of the skeletal relationship by measuring the ANB angle: Class I = 0–4°; Class II = >4° and Class III = <0°: the statistical analysis was done with the SPSS V program.22.0 for Windows using the Chi-square tests. Results: Of the 925 digital strict lateral radiographs evaluated, 283 radiographs were found to present ponticulus posticus and the highest frequency was found in the absent type (69.4%), the partial type (17.1%) and the complete type (13.5%). The ponticulus posticus was present in 25.1% of the female and 38.4% of the male. The skeletal relationship associated with ponticulus posticus was present in Class II (19.1%), Class I (10.4%) and Class III (1.1%). Conclusions: The ponticulus posticus is an anatomical variant present in 30.6% of cases. No statistically significant difference was found between the presence of ponticulus posticus and skeletal relationship or sex.

Objective: To evaluate the clinical and radiographic results and complications of arthroscopic subcapital realignment osteotomy for the treatment of chronic and stable proximal femoral epiphysiolysis (PFE) in an initial series of patients. According to the literature review, the study presents the first description of an arthroscopic technique of this type of osteotomy. Methods: Between June 2012 and December 2014, seven patients underwent arthroscopic subcapital realignment osteotomy for the treatment of chronic, stable PFE. The mean age of the patients was 11 years and four months. Minimum follow-up ranged from 6 to 36 months (mean, 16.5 months). Patients were clinically evaluated according to the Harris Hip Score modified by Byrd and radiographically according to Southwick’s quantitative classification and the epiphyseal-diaphyseal angle. Postoperative complications were analyzed. Results: With regard to the evaluation of the Harris Hip Score Modified by Byrd clinical score, a preoperative mean of 35.8 points and a postoperative mean of 97.5 points were observed (p < 0.05). Radiographically, five patients were classified as Southwick grade II and two as grade III. A mean correction of the epiphyseal-diaphyseal angle of 40° was observed. There were no immediate postoperative complications. One patient developed avascular necrosis of the femoral head, without collapse or chondrolysis at the last follow-up (22 months). Conclusion: The arthroscopic technique presented by the authors for the treatment of chronic, stable PFE resulted in clinical and radiographic improvement of the patients in this initial series.

The paper lays out basic design options for infrastructure policy. It first sketches mechanisms to assess demand. Then it sets out a hierarchy of issues starting with choice of market structure followed by conduct regulation. Ownership options are largely a function of market structure choices. The implications for finance—the topic of much day-to-day discussion in infrastructure policy-making—follow from these various prior choices. The discussion naturally circumscribes the role for the so-called public-private partnerships, their uses and pitfalls.